Prosthetic Valve Endocarditis From Trichosporon asahii in an Immunocompetent Patient

Paniagua, Lizy; Sudhakar, Deepthi; Perez, Lara Erika; Miranda, David; Ureña, Pedro; Gregorič, Igor D.; Kar, Biswajit; Jneid, Hani; Ramirez, J Avila; Paniagua, David

doi:10.1016/j.jaccas.2020.03.017

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…Overall, Staphylococcus aureus is the most common cause of IE and is responsible for 31% of cases [4]. IE secondary to anaerobic bacteria, such as Bacteroides, is a rarer occurrence and has a mortality rate of 21-43% while IE from Candida species is rarely seen in immunocompetent individuals and most cases are only able to be definitively diagnosed post-mortem [5][6][7]. The mortality rate associated with IE due to Candida species is as high as 46.6-50.0%, making timely diagnosis and treatment of paramount importance [7].…”

Section: Discussionmentioning

confidence: 99%

Candid and Fragile: A Case Report of Infective Endocarditis From Candida albicans and Bacteroides fragilis

Troxel¹,

Ogan²,

Conner³

2023

Cureus

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Infective endocarditis (IE) remains a significant cause of mortality worldwide and reported cases are continuing to increase annually. We describe a case of a patient who would undergo coronary artery bypass grafting (CABG) with bioprosthetic aortic valve replacement complicated by postop gastrointestinal bleeding requiring partial colectomy with ileocolic anastomosis who would later present with fever, dyspnea, and persistently positive blood cultures who would be found to have tricuspid valve endocarditis from Candida and Bacteroides species that was successfully treated with a combination of surgical resection and antimicrobial therapy.

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Section: Discussionmentioning

confidence: 99%

Candid and Fragile: A Case Report of Infective Endocarditis From Candida albicans and Bacteroides fragilis

Troxel¹,

Ogan²,

Conner³

2023

Cureus

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“…Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) has been developed to sequence proteins, map biomolecules in tissues, identify microorganisms, and analyze several biochemical assays in a short time. It was used in five patients with Candida infection [52,63,66,68,72] , and in 5 patients with other species [109,111,[113][114][115][116] , but not with Aspergillus. Quantitative polymerase chain reaction (qPCR) with genetic sequencing was performed in only one patient with Candida infection [71] , three with Aspergillus infection [81,92,95] , and for several other microorganisms [112,117,122,124,125] .…”

Section: Case Reportsmentioning

confidence: 99%

“…C. parapsilosis poses specific problems: it is a nosocomial microorganism on the rise, with often a delayed identification in blood culture [11] , and a different type of biofilm compared to C. albicans. Biofilms are responsible for certain types of resistance [109,110] , but Amphotericin can still act on it [49,52,82,92] . Antifungal susceptibility testing with minimal inhibitory concentrations with appropriate cut-off values is needed, especially when resistance is suspected [65,72,92] .…”

Section: Other Imaging Modalities In Fungal Iementioning

confidence: 99%

“…Antifungal susceptibility testing with minimal inhibitory concentrations with appropriate cut-off values is needed, especially when resistance is suspected [65,72,92] . Echinocandins are also recommended against Candida [16,49,56,76] because of their activity against fungal biofilms [65,109] . Afterwards, a step down towards oral fluconazole is possible if the microbial agent is susceptible [46,53] .…”

Section: Other Imaging Modalities In Fungal Iementioning

confidence: 99%

“…It was administered in patients with C. parapsilosis [45,46,[49][50][51][52] and other Candida species [63,65,70] or a combination of Candida with a bacterial IE [74,75,77] , but not in patients with C. albicans infection. It has also been applied in several species of Aspergillus [81,82,[84][85][86][87]89,90,92,[95][96][97][98] , one patient with Cryptococcus [100] , all patients with Histoplasma [104][105][106][107] and Trichosporon [109][110][111][112] , as well as in some other fungal species [112,113,116,117,[121][122][123][124] . Nevertheless, it was reduced in dosage in one of the cases [124] and had to be discontinued in two other cases with renal failure [116,121] .…”

Section: Medical Treatment Of Fungal Ie In the Acute Phasementioning

confidence: 99%

See 2 more Smart Citations

“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

Mistiaen

2024

Vessel Plus

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Fungal infective endocarditis is a rare but highly lethal condition. Its diagnosis is often delayed due to nonspecific symptoms, inconclusive medical imaging, and negative blood cultures. Recent reviews of cases and series over the last 5 years indicate that the condition remains rare and lethal. If fungi are identified as the causative agents in more than 5% of patient cases with infective endocarditis, it is likely that risk factors such as immune suppression or cardiac implants are probably involved. A series derived from recent case reports indicates that Candida and Aspergillus are still the main causative infectious agents, with. C parapsilosis on the rise. From these cases, diagnostic clues (frequent embolisms, ophthalmic involvement, large, mobile and friable vegetation, non-valvular cardiac manifestations) are pointing towards fungal IE. These reports, however, are not standardized and a publication bias towards rare microorganisms or towards a favorable outcome might exist. Complications might be underreported, and important data such as diagnostic delay are absent or difficult to retrieve. Pharmacologic treatment is not fully standardized. Knowledge of resistant strains in this respect is important. Statistical analysis for the effect of complications and treatment modalities on outcome shows that any result should be treated cautiously. The current series is by no means a valid substitute for a well-designed series of fungal endocarditis. However, the better outcome with Candida and patients treated with surgery confirm earlier results. An international multicentric standardized registry of cases with fungal endocarditis in order to improve the outcome of this disease is highly needed. The effect of diagnostic delay on outcome remains elusive and should be resolved.

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Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

et al. 2023

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Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use.

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Prosthetic Valve Endocarditis From Trichosporon asahii in an Immunocompetent Patient

Cited by 4 publications

References 9 publications

Candid and Fragile: A Case Report of Infective Endocarditis From Candida albicans and Bacteroides fragilis

Candid and Fragile: A Case Report of Infective Endocarditis From Candida albicans and Bacteroides fragilis

“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

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